Retropubic suspension is surgery to help control urine leakage that can happen when you laugh, cough, sneeze, lift things, or exercise ( stress incontinence). The surgery helps close your urethra (the tube that carries urine from the bladder to the outside) and the bladder neck (the part of the bladder that connects to the urethra).
Open retropubic colposuspension; Laparoscopic retropubic colposuspension; Needle suspension; Burch colposuspension
You will have either general anesthesia or spinal anesthesia before the retropubic suspension procedure. With general anesthesia, you will be asleep and feel no pain. With spinal anesthesia, you will be awake but numb from the waist down. You will not feel pain.
There are two ways to do retropubic suspension: open surgery or laparoscopic surgery. Either way, surgery may take up to 2 hours.
During open surgery:
During laparoscopic surgery, the doctor will make a smaller cut in your belly. A a tube-shaped medical device that allows the doctor to see your organs (laparoscope) is put into your belly through this cut. The doctor will sew the bladder neck, part of the wall of the vagina, and the urethra to the bones and ligaments in the pelvis.
This procedure is done to treat stress incontinence.
Most of the time, your doctor will have you try bladder retraining or Kegel exercises before talking about surgery with you.
Risks for any surgery are:
Risks for this surgery are:
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the days before the surgery:
On the day of your surgery:
You may be asked to shave your pubic area before the operation.
Most people will have a catheter in their urethra or above their pubic bone after this surgery so that urine can drain from the bladder. Some people may need to go home with a catheter still in place, or they may need to perform intermittent catheterization. This is a procedure where you use a catheter only when you need to urinate. You will be taught how to do this before you leave the hospital.
Many patients leave the hospital on the same day as surgery. Sometimes, patients stay for 2 or 3 days after this surgery.
You may have gauze packing in the vagina after surgery to help stop bleeding. It is usually removed a few hours after surgery.
Urinary leakage decreases for most women who have this surgery. But you may still have some leakage. This may be because other problems are causing your urinary incontinence. Over time, some or all of the leakage may come back.
Chapple CR. Retropubic suspension surgery for incontinence in women. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:chap 65.
Takacs EB, Kobashi KC. Minimally invasive treatment of stress urinary incontinence and vaginal prolapse. Urol Clin North Am. 2007;35(3):467-476.
Dmochowski RR, Blaivas JM, Gormley EA, et al. Female Stress Urinary Incontinence Update Panel of the American Urological Association Education and Research, Inc, Whetter LE. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183:1906-1914.